Who is Simon Wessely?

This is the perfect summary of Simon Wessely's career. He is a hack, but a very successful one. By now he fully knows that his nonsense has been disastrous but he is perfectly content with letting millions suffer and die needlessly to keep his reputation and privilege intact. I expect increasingly more sabotage from him against any promising research, he simply can't face the reality of what he did.

He is a doctor who does harm, knowingly and willfully. By mistake, initially, but that excuse is now so old it can legally drink in a pub. I was told that this is a bad thing, but apparently when nobody cares about those suffering, it doesn't really count. Turns out the Prime Directive of medicine is as much of a feel-good slogan as it is in Star Trek, easily brushed aside, although in Wessely's case it's entirely for self-interest rather than trying to do some good.

In hindsight he will be judged as a monster, but he will likely be long dead by then. Progress in medicine truly happens one funeral at a time.

 

But ME isn’t psychiatric and when people have the type of symptoms you describe, I have and know many, it isn’t related to clinally significant alterations in mood and behaviour. My consultant came to See me when I I had a severe relapse. I ranted and raved because I wasn’t handling it but , fortunately, he told my parents she’s thoroughly fed up but she’s not depressed. Wessely did us all great disservice by deliberately blurring these lines to suit his own ends, how many people insult me by acting as if I just need activity m encouragement, positivity and cheering up etc, all the result of the mind -body, psychological factors narrative , rather than support me as they would if I had MS caused disability.
On the climate program recently it was argued people with vested interests went out of their way to keep climate a debate, grey area, controversial issue and that’s all they had to do to maintain status quo, stalemate inaction until we have almost hit the emergency wall. Whilst SWs comments can be seen as reasonable they could also be part of what I interpret as a deliberate effort to perpetuate past BPS narratives and keep a biomedical understanding potential seen as dubious

Just because Simon Wessely recognises a biological basis for psychiatric illness, he’s not treated ME as psychiatric ibut psychological. The difference between a lot of mental illness causing disability and ME is rehabilitation techniques often seem to help and recovery is often touted as highly achievable by wessely and co as good news in mental illness. Unfortunately applying the same attitude to ME has not been helpful to us in the severe category

 

I was just looking into this recently after he claimed as much on Twitter. Many of his papers in the late 80s and into the 90s are concerned with the biology of this illness even if they have a psychiatric slant. He claimed to have made some findings RE cortisol. Anyone have more information on this? I mean I could read the papers, but just wondering if anyone has written on this aspect of his work and these late 80s/early 90s studies?

 

He is the epitome of the sort of person who can fall into a pile of poo and come out smelling of roses.

 

It's just annoying that the same people who publish and/or defend harmful junk science then caution again overoptimism.

 

Well said. To speak the truth, I thnik @Jonathan Edwards has a point, psychology can contribute to the illness and although I have little to back that up with, I think it is true to some extent and only applies to SOME but not all. With that said, when we acquire CFS, that stressor (whether that is psychological or not) has already affected one or more biological systems that removing the stressor wont result in significant improvement if at all. Therefore, psychiatry is not the solution for at the stage of CFS, that door has closed.

 

No, I wasn't implying it was. I was implying that categories like 'biological' don't necessarily help people understand what the distinctions are.

I doubt that is the case, actually. For most psychiatric illness 'rehabilitation techniques' are a waste of time I suspect.

I think most psychiatric diseases really have nothing to do with what people call 'psychological'. Which is why it always seemed to me foolish to rename psychiatry psychological medicine. Maybe we need to go back to the days when neurological diseases included illnesses where nothing specific has been found yet.

 

It's deliberate. "Rousing reassurance" is literally giving false hope, "there is no disease", "by being here, you are already on your way to recovery". It isn't like it, it is. Promoting without evidence a cure for a disease as disabling as MS that consists of shouting at your symptoms is the epitome of giving false hope, yet they don't think twice about throwing bullshit back.

The substance of their words and explanations isn't nearly as important as its narrative. But they know what they're doing, they just don't understand it.

 

Perhaps best characterized by his statement in 1994: "I will argue that ME is simply a belief, the belief that one has an illness called ME".

 

some could argue that he has been the greatest asset that the insurance industry has ever had . the ability to obfuscate diseases out of existence is quite the trick. who benefits the most when patients are disenfranchised by psychiatry . the state and of course insurance industries .

 

I think that in criticizing Simon Wessely, it is best to focus on him making claims that are not justified by the evidence. For example, the reason why ME/CFS patients suffer the symptoms they have is considered unknown by scientists but Wessely gives the impression he got it all figured out with his theory of fear avoidance. Specialists in ME/CFS agree that there currently is no treatment for the illness, but Wessely claims he can treat and even cure ME/CFS patients using CBT.

I think those are better points to make than that Wessely is suppressing evidence of ME/CFS being a 'neuroimmune disease', that he secretly thinks ME/CFS patients are malingering or that his goal is to save insurance companies money rather than help patients etc. I think the latter arguments are making things more complex needlessly.
The first argument is not only the one we absolutely know for sure it is also the argument that is most likely to convince other scientists that Wessely's publications are flawed.

 

I concur, if the audience is scientists, give them good quality science.

If the audience is the general public, they may respond more to the oppressive social/power dynamics of status and money (based on their own experiences).

So we may need different messages for different audiences for them to end up at the same place: Wessely's work is fake.

 

I think you misspelled "incompetent" there. He was knowingly doing just enough to cast doubt on the biology of the ME so that he could promote his own theories.
The cortisol paper is particularly bad [eta: the first one - there are *lots*]. It relies on the premise that if you can fix one symptom, you can fix the entire condition.

Prof Martin Bland found one of his studies years later and destroyed it (OK - it's epidemiology not immunology - but that's supposed to be SW's specialist subject) - but SW got away with it because of an error made by BMJ Editorial.
(Discussed here: https://www.s4me.info/threads/who-said-dont-bother-testing-patients.6532/page-14#post-146224 )

I'm pretty sure that there are other instances where they did find things, but buried it under doubtful interpretation. Just wait. When things start turning south, they will wheel these papers out to show that they were on the patients' side all along.

[eta: Hedging...
Hypocortisolism in CFS is potentially reversible by CBT.
Low cortisol is ... associated with a poorer response to CBT.]

 

There was also his comment in the Elliot Slater lecture, I probably paraphrase, "What's a little up or down regulation between friends?" One has to make certain allowances for the forum and the nature of the speech, but that does cast some doubt on the seriousness of the enterprise. If I recall correctly, which would be unusual, that was concerned the altered prolactin response to challenge with buspirone.

 

Indeed. As was the case with NIH´s director Francis claiming that they funded the search expedition for a biomarker
https://twitter.com/user/status/1124238145103568896

 

If you said to a person that knows little about ME/CFS:

Many things written about ME/CFS in textbooks and published peer reviewed science papers are false, doctors hold misconceptions about the illness, Cochrane and The Lancet are biased and wrong, there is no reason to believe patients can reverse their illness with positive thinking and exercise, and the people meant to be helping us are hurting us and are blind to the harm.

Then it sounds like you're crazy, even if it's the truth.

So it is maybe not that bad to say that the people working for the health insurance industry will take the position that ME/CFS is not a condition deserving benefits.

It is difficult to understand how the situation could have gotten so out of control merely by incompetence. There is reason and logic behind the way things are, it's just not the kind of reason and logic that are concerned about truth and helping patients.

 

I agree

 

But that is the history of ME/CFS, which is also an important story to tell. Wessely is the father of the "all in the mind" view of ME/CFS, and he played a fundamental role in turning ME/CFS into a condition that, from around the 1990s onwards, most medics started viewing as psychogenic.

Before Simon Wessely entered the ME/CFS field in the late 1980s, ME/CFS was generally considered biologically caused, after it came to prominence after the 1955 Royal Free outbreak. (There was the small issue of those dubious dilettantes McEvedy and Beard throwing out an unevidenced idea in the 1970s that the Royal Free ME/CFS outbreak was mass hysteria, but that idea was soon refuted).

But Wessely and his band of Wessely School psychiatrists, plus a few likeminded people abroad (no more than a dozen or so people in total), single-handedly persuaded the much of the world to adopt the (erroneous) view that ME/CFS is an "all in the mind" condition, in spite of offering no evidence for this.

So these dozen or so dubious psychiatrists masterminded almost complete control of the whole field of ME/CFS, affecting 17 million ME/CFS patients worldwide. It's an extraordinary phenomenon where just a just a dozen academics can take dominion over a medical field without offering any scientific evidence.

You cannot really understand the Wessely phenomenon without examining Wessely's uncanny ability to manipulate opinion and persuade the medical profession of his unevidenced ideas. Admittedly the Wessely School were working in cahoots with the disability insurance industry, in whose financial interests it was to make ME/CFS look like a psychologically caused condition. So the Wessely School had some help. Nevertheless, it is remarkable how just a dozen psychiatrists could radically change perceptions on ME/CFS, and recast this disease into a psychogenic condition.